Traumatic hip dislocations occur in children below 15 years old. Just as in adults, posterior hip dislocations are 10 times more common than anterior hip dislocations. Traumatic hip dislocation in pediatric patients < 10 years of age requires much less force than that in an adult, while in children over 10 years old, We reported a 4-year-old boy with traumatic hip dislocation. Closed reduction with the Bigelow manoeuvre was applied without general anesthesia in the Emergency room. Patient was followed up for 4 weeks in a hip spica cast. There were no problems at the 6-month follow-up examination. Traumatic hip dislocation in children is not a common event and is generally caused by minor trauma.
Traumatic hip dislocation is a relatively uncommon event in childhood. Only 5% - 6% of dislocations occur in children aged below 15 years of age. The prognosis differs from dislocations in adults in terms of the mechanism of the trauma. Traumatic hip dislocation in pediatric patients < 10 years of age requires much less force than that in an adult, while in children over 10 years old, it is generally the result of high-energy traffic accidents or motorsports-related activities [
A 4-year-old boy presented at the Emergency Department with complaints of pain in the left hip and restricted motion of range following a fall at home. Physical examination revealed shortness in the left lower extremity, in addition to flexion, adduction and internal rotation deformity in the left hip. Vascular system and neurological evaluation revealed no pathological finding. Radiographic evaluation disclosed posterior traumatic hip disloca- tion (
The patient’s family was informed that data concerning his case would be submitted for publication.
Traumatic hip dislocation is very rare in children. Cases in young children < 14 years old, are less than 5% of
adult cases. In addition, paediatric traumatic hip dislocation occurs from a small trauma. Accompanying fractures of the femoral head and acetabulum are more rare, and complication rates are lower than in an adult group. Boys are reported to be affected four times more than females. In literature, the patients have been evaluated in two groups, as those aged 2 - 8 years old with minor trauma and those aged 9 - 15 years old who have sustained the injury subsequent to major trauma such as motor vehicle accident. In adults, high energy trauma is the general rule. Standard anteroposterior and lateral pelvis radiographs should be taken [
In adults, MRI has been seen to be an effective evaluation method of accompanying injuries associated with acetabular fractures. F. Ivan et al. reported two cases, where MRI showed the true size of the posterior wall damage, which was not seen on plain radiographs or CT scans and thereby explained the etiology of post- reduction instability [
Complications that may develop following traumatic hip dislocations in children include avascular necrosis, traumatic arthritis, heterotopic ossification, sciatic nerve paralysis, coxa magna, femoroacetabular impingement. In one case, MRI more clearly characterized the injury. As the ossification of the posterior wall is completed during adolescence, MRI may be a useful tool in revealing these fractures and helping with surgical planning [
In avascular necrosis, the most important factors are the time until reduction not exceeding 24 hours, severe trauma in children over 6 years old and accompanying fracture. Although it has been stated that avascular necrosis generally develops within the first three years, these children should be closely monitored until their growth is complete.
Neurological damage has been reported to be observed in 20% of cases in the form of neuropraxia affecting the sciatic nerve and this usually recovers spontaneously [
Although rates of recurrent dislocation have been reported as higher in paediatric patient groups than in adults, this complication is rare. Capsular rupture or capsular failure are the etiology of recurrence. Therefore, patients with capsular rupture should be evaluated with arthrography and treated with surgical repair. Acute redislocation can be explained by hip instability when good reduction is not obtained because of a labral rupture or an osteoarticular fragment in the hip joint. Patients should be evaluated with CT and if there is any suspicion, treatment by open reduction must be applied [
Traumatic hip dislocation in children is not a common event and is generally caused by minor trauma. As particular problems develop when diagnosis is delayed or neglected in cases of multiple trauma, the pelvis of all multiple trauma patients should be evaluated radiographically. Although complication rates are lower in adults, the time of reduction is important for a successful outcome.
The authors have no conflicts of interest to disclose.
Thanks to the child’s family for allowing the publication.